The candidate is an assistant professor of pediatrics and a developmental-behavioral pediatrician. Dr. Sices' goals are to develop an independent research career to improve the early identification and initial management of developmental conditions in children. Delays in development in young children predict developmental problems such as autism, mental retardation, and learning disabilities. Early recognition and treatment can significantly improve outcomes; however, many children are not identified in time to benefit from federally-mandated early intervention and preschool treatment services. Although primary care physicians are positioned to identify affected children because they see young children for multiple preventive care visits before age 5, these problems are often first identified by educators at school entry. The specific aims of Dr. Sices' proposed research are 1) to identify factors that affect the delivery of preventive developmental services by primary care physicians; and 2) to develop an innovative intervention to improve the detection and initial management of developmental delays in young children. Two projects are planned during the period of the award. Study 1 is a qualitative assessment of factors that act as barriers or promote the identification of developmental problems in young children. The study will examine parents' and physicians' experiences with communication about child development during preventive care visits. Study 2 is the development and pilot testing of an intervention that incorporates structured developmental assessments at specific preventive care visits and provides focused physician and parent education. In order to achieve these goals, Dr. Sices requires additional training in specific research methods, data analysis and manuscript preparation. She will work with a group of mentors in her field who are exceptionally qualified to assist her with this training, including Dennis Drotar, Ph.D. (sponsor), Kurt Stange, M.D., Ph.D., Frances Glascoe, Ph.D., and Kelly Kelleher, M.D., M.P.H.